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Wheelchairs and Weight Control

As we age and are active in life, damage to our joints, particularly those associated with movements of the lower body, inevitably occurs. Given this fact, so many people get on a “medical conveyor belt” involving joint replacements, pain medications, weight gain, type II diabetes, etc. Unfortunately, all these medical interventions are rarely successful in curing the underlying process, leaving people overweight, inactive, depressed and often dependent on awkward-to-handle mobility scooters to go very far at all. 

In view of the negative outcomes so often associated with medical histories such as discussed immediately above, it would seem that many people might consider it rational to begin using a custom manual wheelchair earlier on in the progression of lower extremity problems. They could, thus, avoid surgeries, reliance on narcotic medications, inactivity, depression, weight gain, etc., sparing society many of the expenses associated with these medical conditions and treatments. Of course, there are profound psychological implications of “being in a wheelchair,” as well as potential societal effects of having more people rolling around in public places while fewer are having surgeries and taking prescribed narcotics. Sandy’s Journey from Painful Movement to Free Wheeling I’d like to introduce Sandy, a woman whose personal experience with injury, weight gain and chronic pain led her to choose wheeling over struggling to walk. Here is her story in her own words: Battling Weight and Mobility Issues This part of my life story involves two interacting problems—my weight and my back. I was a chubby teenager, and as a young woman I was 5’5” and about 180 pounds. I was confident, flaming red hair, dressed well and was very outgoing. I dated a lot and married. Of course, bearing children didn’t do either of my challenges any good! At work a number of years ago, I stood up from my desk and felt an intense, shooting pain down my right leg. A simple discectomy/laminectomy seemed to fix that, and I went on with my life. However, further spinal problems developed, which I later learned related to a weakness among members of my biological family (I was adopted shortly after birth.). So I had to have more extensive surgery, including the installation of a cage in my lumbar spine and an electrical stimulator. When I had recovered from this surgery sufficiently to be interested in such things, I weighed myself. The scale said 240 pounds! As the kids say, “I freaked and pushed the panic button BIG TIME.” But I launched into solution-mode—I watched my food choices and intake, and spent hours working out in a gym. Eventually, I was able to walk long distances to burn more calories. It was hard work, but I am proud to say that I brought my weight down. A major threat to maintaining a healthy weight, as well as to other aspects of my life, occurred several years ago when I fell and broke my already weakened back at the T-11 level. For a time, I was completely paralyzed from my waist down, but I gradually gained the ability to hobble around slowly and painfully with the aid of a cane. 

One of my major weapons in fighting weight gain had been taken from me. I could no longer “power walk” to burn calories. Even so, I was determined to prevent the weight from coming back! I figured the only thing I could do was to, literally, starve myself. My caloric intake plummeted. Many days I would survive on just a candy bar and a bottle of vitamin-enriched water. While this regime did keep my weight in check, my unhealthy decisions adversely affected my wellness, specifically my heart, blood sugar levels and my teeth and gums. Not a good trade-off and not an example I would want anyone to follow! The man I was with at the time couldn’t accept my new mobility challenges. He was clearly embarrassed to be seen with me as I limped along. And he absolutely refused to help me go places, like to the children’s school events, where I would have had to use a wheelchair to do so. Of course, I shouldn’t have been surprised at his reactions here in that he had never even fully accepted my need to wear eyeglasses! Supportive Friends and Smarter Choices Helped Both Fitness and Mobility Issues It was during this troubled time in my life that I reestablished contact with a former colleague and boyfriend. Bill, I learned, had himself had severe back problems which had left his legs so weak that he now uses a wheelchair for mobility. We agreed to meet in Las Vegas for a week to renew or relationship. 

As we were making plans for the trip, I felt it only fair to warn Bill that I would be slow in moving about and that there could well be places I wouldn’t be able to go because of my pain level. He responded to my warning by saying, “Well, why don’t you use one of my spare chairs to see if that would help you get around better and in less pain?” He asked that question quite matter-of-factly, but I was initially shocked! I had understood from my treatment providers over the years that the purpose of all my surgeries, physical therapy, etc. was to keep me walking and out of a wheelchair. After all that, here is someone suggesting that I “put myself in a wheelchair.” I could only mumble, “Well,…uh…we’ll see.” 

The last thing I did before leaving home was to weigh myself. As I was being driven to the airport for my flight to Las Vegas, I worried about how much weight I’d gain in The Land of Booze and Buffets. I knocked on the door of the hotel room Bill and I would be sharing for the next week. He opened the door by pulling himself backward in his little wheelchair. He looked much as I remembered him—perhaps a few more gray hairs. But being a wheeler had noticeably broadened his shoulders and expanded his chest, not unattractive changes in my book. Of course, his legs looked smaller by comparison. 

After a quick hug, it was all I could do to limp to the bed and collapse on it. As I lay there, I noticed that he had taken my cane and put it somewhere and that there was another wheelchair in the corner of the room. I had never before even seen a wheelchair that small, since I had only been exposed to the heavy, clunky hospital chairs. He pushed the other wheelchair over and suggested that I try it to see if it might make things easier for me. As I couldn’t see how at that point anything could make me feel worse, I lowered myself gingerly into it. Bill showed me how to lean back in the chair so that the weight of my upper body would be borne by the backrest, thus protecting my very sensitive lower spine. Quite unexpectedly, I begin to feel pleasantly supported and comfortable. 

As we rolled together down to the lounges and restaurants, I was struck by how easy it was to push myself along. I also discovered that rolling was much, much less jarring to my spine than walking, particularly in comparison to limping about unbalanced on a cane. By the time we got to the restaurant, I was actually feeling pretty good! Our life over the next week was eye-opening for me. We rolled everywhere and missed nothing, from The Strip and to see the Fremont Experience, the laser show downtown. Looking back, this exercise, in addition to burning calories, was building up my shoulders and arms, making going places in a wheelchair easier and faster for me as time has gone by. All this activity created a healthy appetite and, for the first time in years, I allowed myself to eat until I was no longer hungry. Psychologically, this week in a wheelchair was very positive for me. I was in less pain and needed less medication, for one thing. I didn’t feel that anyone pitied me as I zipped around in my sporty little wheelchair. I actually felt considerably better about myself on wheels, than I would ever have perspiring and moving slowly hunched over my cane. And though I fed my healthy appetite in the Land of Booze and Buffets, thanks to all my wheeling, I didn't gain a pound! 

Sandy’s Happy Ending Bill and I are now working and living together. This is not only a dream come true, and I didn’t even have to buy myself a wheelchair! In planning our next cruise vacation, I’ve already made sure that the ships are wheelchair-friendly and selected a cruise where all of the ports are directly accessible by simply rolling down a ramp from the ship. Late September sounds like a good time to be rolling around the Caribbean, don’t you think? My experience has inspired me to offer groups on weight control, the area of my master’s thesis. These groups will particularly target women with mobility problems, like myself. For the theoretical background for my techniques, I will be looking to the weight control chapter in Health and happiness: A holistic Approach by Wildman and Rogina (Trafford Publishing, 2015). This model of weight control recommends a modest decrease in calories consumed and a larger increase in energy expenditure. To increase caloric output, I plan to advocate with these mobility-impaired women the use of a lightweight wheelchair, which worked so well for me. I find it to be ironic that as I was going through all my orthopedic procedures, the brochures in the doctors’ offices warned that people who go into wheelchairs will gain weight. My use of a wheelchair, in contrast, has actually controlled my weight! Recently, I was in a “big box” store. As I was gliding comfortably in my little chair, I saw others struggling in pain to get down the aisles. It struck me that that used to be me 

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